Objective To clarify the risk factors of diaphragmatic dysfunction (DD) after cardiac surgery with extracorporeal circulation. Methods A retrospective analysis was conducted on the data of patients who underwent cardiac surgery with extracorporeal circulation in the Department of Cardiovascular Surgery of Peking University People's Hospital from January 2023 to March 2024. Patients were divided into two groups according to the results of bedside diaphragm ultrasound: a DD group and a control group. The preoperative, intraoperative, and postoperative indicators of the patients were compared and analyzed, and independent risk factors for DD were screened using multivariate logistic regression analysis. Results A total of 281 patients were included, with 32 patients in the DD group, including 23 males and 9 females, with an average age of (64.0±13.5) years. There were 249 patients in the control group, including 189 males and 60 females, with an average age of (58.0±11.2) years. The body mass index of the DD group was lower than that of the control group [(18.4±1.5) kg/m2 vs. (21.9±1.8) kg/m2, P=0.004], and the prevalence of hypertension, chronic obstructive pulmonary disease, heart failure, and renal insufficiency was higher in the DD group (P<0.05). There was no statistical difference in intraoperative indicators (operation method, extracorporeal circulation time, aortic clamping time, and intraoperative nasopharyngeal temperature) between the two groups (P>0.05). In terms of postoperative aspects, the peak postoperative blood glucose in the DD group was significantly higher than that in the control group (P=0.001), and the proportion of patients requiring continuous renal replacement therapy was significantly higher than that in the control group (P=0.001). The postoperative reintubation rate, tracheotomy rate, mechanical ventilation time, and intensive care unit stay time in the DD group were higher or longer than those in the control group (P<0.05). Multivariate logistic regression analysis showed that low body mass index [OR=0.72, 95%CI (0.41, 0.88), P=0.011], preoperative dialysis [OR=2.51, 95%CI (1.89, 4.14), P=0.027], low left ventricular ejection fraction [OR=0.88, 95%CI (0.71, 0.93), P=0.046], and postoperative hyperglycemia [OR=3.27, 95%CI (2.58, 5.32), P=0.009] were independent risk factors for DD. Conclusion The incidence of DD is relatively high after cardiac surgery, and low body mass index, preoperative renal insufficiency requiring dialysis, low left ventricular ejection fraction, and postoperative hyperglycemia are risk factors for DD.

Gastric cancer (GC) is one of the most common malignant tumors of the digestive system in China. With the progress of immunotherapy research, programmed death receptor-1 (PD-1) inhibitor-based combinatory therapy offers new ideas for the treatment of advanced gastric cancer. In recent years, with the increasing status of immunotherapy in the treatment of advanced gastric cancer, a growing number of domestic and international clinical studies shown that immunotherapy could achieve better efficacy in the neoadjuvant therapy and conversion therapy for patients with advanced gastric cancer. This paper reviews the current research progress on the application of PD-1 inhibitors in the neoadjuvant therapy and conversion therapy of gastric cancer.

Our acupuncture-moxibustion(Acu-Moxi)field has entered an era of digital and intelligent transformation,yet systematic and in-depth development remains limited.This article aims to provide an overview and reflection on the digital and intelligent progress of Acu-Moxi in China,offering systematic insights for the comprehensive development of this field.Through a retrieval from CNKI,VIP,and Wanfang databases,along with a discussion of relevant policies,case studies,achievements,and updates,the study evaluated the current advancements in the digitization and intelligence of Acu-Moxi,also discussing the current advantages and challenges.Findings revealed an overall upward trend in publications related to digital-intelligent technologies in Acu-Moxi,key forms including robotics,acupuncture point digitization,smart acupuncture devices,and clinical decision-making models,highlighting the empowering potential of digital intelligence across the discipline.Recently,publications of the Acu-Moxi digitization has decreased sharply,and the number of Acu-Moxi research about digital and intelligent transformation has increased.In conclusion,the field has undergone a transition from comprehensive digital accumulation to increasing intelligence,moving toward integrated digital-intelligent development.However,the internal development of digital and intelligent Acu-Moxi remains uneven.To achieve a harmonious intelligent Acu-Moxi ecosystem,it is crucial to leverage opportunities of discipline and times for systematic and balanced improvement.

Our acupuncture-moxibustion(Acu-Moxi)field has entered an era of digital and intelligent transformation,yet systematic and in-depth development remains limited.This article aims to provide an overview and reflection on the digital and intelligent progress of Acu-Moxi in China,offering systematic insights for the comprehensive development of this field.Through a retrieval from CNKI,VIP,and Wanfang databases,along with a discussion of relevant policies,case studies,achievements,and updates,the study evaluated the current advancements in the digitization and intelligence of Acu-Moxi,also discussing the current advantages and challenges.Findings revealed an overall upward trend in publications related to digital-intelligent technologies in Acu-Moxi,key forms including robotics,acupuncture point digitization,smart acupuncture devices,and clinical decision-making models,highlighting the empowering potential of digital intelligence across the discipline.Recently,publications of the Acu-Moxi digitization has decreased sharply,and the number of Acu-Moxi research about digital and intelligent transformation has increased.In conclusion,the field has undergone a transition from comprehensive digital accumulation to increasing intelligence,moving toward integrated digital-intelligent development.However,the internal development of digital and intelligent Acu-Moxi remains uneven.To achieve a harmonious intelligent Acu-Moxi ecosystem,it is crucial to leverage opportunities of discipline and times for systematic and balanced improvement.

Gastric cancer (GC) is one of the most common malignant tumors of the digestive system in China. With the progress of immunotherapy research, programmed death receptor-1 (PD-1) inhibitor-based combinatory therapy offers new ideas for the treatment of advanced gastric cancer. In recent years, with the increasing status of immunotherapy in the treatment of advanced gastric cancer, a growing number of domestic and international clinical studies shown that immunotherapy could achieve better efficacy in the neoadjuvant therapy and conversion therapy for patients with advanced gastric cancer. This paper reviews the current research progress on the application of PD-1 inhibitors in the neoadjuvant therapy and conversion therapy of gastric cancer.

Influenza imposes a significant disease burden on society and individuals annually, and influenza vaccination is considered a significant public health measure to prevent influenza and reduce influenza-related severe disease and death. The low influenza vaccination rate in China is partly due to certain factors affecting the willingness and behavior of individuals to receive them. Scientific research and targeted interventions on these factors can effectively improve the vaccination situation. Commonly used individual-level theoretical models for influenza vaccination behavior include the health belief model, protection motivation theory, and theory of planned behavior. This study reviews theoretical models commonly employed in researching influenza vaccination willingness and behavior. An overview of these practical applications and challenges models is presented to provide references for relevant research and intervention programs in China.

Objective:To analyze the epidemiological characteristics of indigenous 2019-nCoV infection in population under 18 years old in 31 provinces of China, and provide evidence for the prevention and control of COVID-19.Method:Demographic and epidemiologic information of children and adolescents with 2019-nCoV infection reported in China between April 29, 2020 and May 31, 2022 were collected from China's Disease Prevention and Control Information System. We analyzed the epidemiological characteristics of the 2019-nCoV infection in children and adolescents and compared the epidemiological characteristics of the cases at different epidemic stages.Result:A total of 63 916 indigenous 2019-nCoV infection cases in children and adolescents were reported in China from April 29, 2020 to May 31, 2022, in which 14 777 (23.12%) were confirmed cases and 49 139 (76.88%) were asymptomatic cases. An obvious incidence peak (40 864 cases) was observed in April, 2022, and two sub-peaks were observed in January, 2020 and January, 2021, respectively. The 2019-nCoV infection cases occurred in 187 cities above prefecture level in 30 provinces, the cases reported in Shanghai (41 562 cases), Changchun (5 753 cases) and Jilin (3 888 cases) accounted for 80.11% of the total cases (51 203/63 916). The proportion of the cases in males was 54.34%. The age of the cases, M ( Q1, Q3) was 10 (5, 14) years, and 57.73% of the cases were 6 - 15 years old. The cases in students accounted for the highest proportion (56.14%). The interval between illness onset and diagnosis of confirmed cases, M ( Q1, Q3) was 1 (0, 2) days. Among the 2019-nCoV infection cases in children and adolescents, 76.88% were asymptomatic, 21.78% were mild ones, 1.32% were moderately severe ones, 0.02% were severe ones, and there were no critical cases and deaths. Compared with other age groups, the proportion of severe or critical cases was higher in children aged <1 year (0.12%). The proportion of asymptomatic infections was highest in Omicron variant epidemic (78.43%). Conclusion:The 2019-nCoV infection cases in children and adolescents aged <18 years in 31 provinces in China were mainly primary and secondary school students aged 6-15 years. Most cases were asymptomatic and mild ones with low clinical severity. It is still necessary to strengthen the surveillance for 2019-nCoV infection in children and adolescents to improve the prevention and control of COVID-19 in school age children.

【Objective】 To identify and propose blood transfusion suggestions for 3 children suspected to have red blood cell T polyagglutination. 【Methods】 According to the RBC reactions with phytohemagglutinin, adult serum and cord blood serum, aggregation test with polybrene reagent and MN antigen phenotype test were carried out on 3 children to confirm the presence of T polyagglutination. The donor serum with negative or weak reactions was selected by minor cross matching for the 3 children who needed therapeutic plasma exchange(TPE). 【Results】 Three cases of RBC T polyagglutination were caused by bacterial infection, with transient appearance of MN antigen; the samples were reactive to peanut agglutinin, soybean agglutinin, adult serum but nonreactive to cord blood serum, and didn′t aggregate after adding polybrene reagent. After receiving timely TPE, the T polyagglutination gradually disappeared. 【Conclusion】 Some bacteria, such as Streptococcus pneumoniae, may cause polyagglutination of red blood cells. The patients with suspected T polyagglutination should be diagnosed in time. For T polyagglutination patients, the minor matched plasma should be used for avoiding the random plasma with anti-T antibody transfusion.

【Objective】 To evaluate the performance of electrochemiluminescence immunoassay (ECLIA) in detecting HIV antigen/antibody in blood screening. 【Methods】 A total of 128 donors, reactive to anti-HIV(ELISA)testing, from September 2016 to September 2020 were enrolled, and seven samples were reactive to double anti-HIV reagents, among which 6 were confirmed by WB, 1 confirmed by NAT as negative.Two group of donors, reactive to solo anti-HIV reagent but being confirmed negative by WB(n=121) vs.randomly selected donors non-reactive to ELISA + NAT(June to September 2020, n=1360), were subjected to HIV antigen/antibody testing using ECLIA to compare the testing results, including concordance rate, sensitivity and specificity. 【Results】 The ECLIA results remained non-reactive for 1360 samples initially non-reactive to both ELISA and NAT.The concordance rate of anti-HIV reactivity by ECLIA and ELISA+ WB were 100%(6/6). For 122 samples, reactive to ELISA anti-HIV testing but nonreactive to confirmatory testing, 4(3.28%)of them were reactive to HIV antigen/antibody testing and 118(96.72%) nonreactive, with the concordance rate of ECLIA and ELISA at 96.88%(124/128). The sensitivity, specificity and false positive rate of ECLIA and ELISA were 100% vs 100%, 99.73% vs 91.77%, and 0.27% vs 8.23%, respectively. 【Conclusion】 ECLIA for HIV antigen/antibody detection has good sensitivity and specificity, which can meet the requirements of blood screening, and the false positive rate is lower than that of ELISA, adopted commonly in blood bank at present.

Domestic and foreign literatures related to the persistence of SARS-CoV-2 and the re-positive cases infected with SARS-CoV-2 were reviewed, and the characteristics and infectivity of the re-positive cases were analyzed to provide scientific evidence for the improvement of case management and the development of measures to stop the spread of SARS-CoV-2. Existing studies have shown that re-positive rate of SARS-CoV-2 ranged from 2.4% to 19.8%, the median of interval between re-positive detection and discharge was 4-15 days. Following the second course of the disease, the anti-SARS-CoV-2 IgM, IgG and IgA positive rates of the cases were 11.11%-86.08%, 52.00%-100.00% and 61.54%-100.00% respectively, the total antibody and neutralizing antibody positive rates were 98.72% and 88.46%. The viral load of the re-positive cases was lower than that in the initial infection. At least 3 380 re-positive cases have been reported globally. SARS-CoV-2 strains were isolated from the samples of 3 re-positive cases (1 immunodeficiency case and 2 cases with abnormal pulmonary imaging). There were close contacts that were infected by an asymptomatic case taking immunosuppressive agents. In conclusion, the infectivity of re-positive cases infected with SARS-CoV-2 is generally very low. Rare re-positive cases infected with SARS-CoV-2 might cause further transmission. The management approach for the re-positive cases can be based on the assessment of the individual transmission risk according to the pathogen detection results.
Antibodies, Neutralizing ; Antibodies, Viral ; COVID-19 ; Humans ; Immunoglobulin M ; SARS-CoV-2